World Immunization Week Webinar Series

International Vaccine Access Center (IVAC)

April 29, 2020

International Vaccine Access Center

8 Practice Areas

Technical leadership on 15+ disease and syndromes

Rooted in Evidence-Policy-Access value chain

2009: Year founded

40: Countries where we work with government and major research institutions

50: Faculty and Staff

The IVAC Team & Where We Work

• Physicians• Professors• Economists • Epidemiologists• Researchers• Advocates

>227: Johns Hopkins students trained from 24 countries

World Immunization Week Activities• Upcoming Webinars: Register – https://ivac.jhu.edu

• Protecting Vaccine Programs in the Era of COVID-19 • April 30th @ 12:00 PM EDT

• Social Media Toolkits:• VoICE: https://immunizationevidence.org/featured_issues/world-immunization-week-2020-toolkit/

• ROTA: https://rotacouncil.org/world-immunization-week-2020-social-media-toolkit/

Presenter

Lois Privor-Dumm, IMBADirector of Policy, Advocacy & Communications

Are we ready to deliver COVID-19 vaccines to older adults?_____________________Lois Privor-DummSr. Advisor, Policy, Advocacy & CommunicationsDirector, Adult Vaccines

World Immunization Week 2020 29 March 2020 | IVAC Webinar SeriesPicture credit: Elderly Health

Today’s Agenda

Why is adult immunization important?

Typologies (archetypes) of adult immunization

programs

Strategies for deploying a COVID-19 vaccine for older

adults

Key vaccines for older adults

Influenza (Flu Vaccine)

Herpes Zoster/ Shingles (HZV)

Pneumococcal Pneumonia(Polysaccharide - PPSV23 & PCV)

Other vaccines may include tetanus, diphtheria, acellular pertussis, hepatitis A&B, measles, mumps, rubella, meningococcal disease, varicella, other regional vaccines.

Why vaccinate older adults?

Reduce premature death and illness

Why vaccinate older adults?

Reduce premature death and illness

Support health, economic and social

benefits

Maintain functional ability

Improved functional ability = better

COVID-19 outcomes

Vaccine Preventable Disease (VPD) can impact functional ability

Time

Heal

th S

tatu

s

Healthy

Frail

VPD onset & outcome

Immunized

Not immunized

Are older adults being immunized?

Which countries have national adult immunization programs

Privor-Dumm et al. Vaccine. 2020.

Existing Public-Sector Programs for Older Adult Vaccines, 2018*

Key: Scope of Vaccines IncludedFlu, Pneumococcal, & Herpes Zoster Flu & PneumococcalFlu onlyNone/unclear/unknown

Sauer et al. Manuscript under preparation. 2020.

0

10

20

30

40

50

60

70

80

AFRO(n=47)

AMRO(n=35)

EMRO(n=21)

EURO(n=53)

SEARO(n=11)

WPRO(n=27)

Worldwide(N=194)

#REF! 3 20 5 35 1 10 74Pneumoccocal 0 10 1 11 0 5 27Herpes Zoster 0 2 0 2 0 1 5

Influenza

* Figure derived from data presented in paper. This is an overview and does not present program nuances (sub-national or national program; level of

funding; priority groups, etc.).

WHO Member States with national adult vaccine policies, 2017

Existing adult vaccine programs are crucial for COVID-19

• Reduce disease• Reduce utilization of hospital beds when they are most needed• Reduce underlying disease which contributes to severe outcomes• Prepare for implementation of a COVID-19 vaccine• Strong childhood programs also an important strategy for adults!

What is needed for national recommendations and high uptake of adult vaccines?

Facilitators of Adult Vaccine National Recommendations

Disease burden

data

Economic data

Surveillance

Adult experts on technical advisory groups

Vaccine policies or

strategies for older adults

Healthy aging

policies or strategies

Stringent requirements for adoption

Health security

focus

Facilitators for Implementing Adult immunization Programs

Publicly financed vaccines

RegistriesUse of

coverage data & targets

Advocacy Influence of champions Access

Equity focusCentralized

vaccine delivery

Centralized health system

Adult vaccine programs: one size does not fit all

Privor-Dumm et al. Vaccine. 2020.

Adult vaccine programs can fit into archetypes

Italy

How we prepare for COVID-19 vaccine may depend on the type of country

Privor-Dumm et al. Vaccine. 2020

Disease prevention Archetype

Health securityArchetype

Evolving adult focusArchetype

Child-focused Archetype

Potential actions: COVID-19 (illustrative)

• Costed policy options• Strengthen

reporting/tracking• Strengthen

messaging• Innovative delivery

(including for current vaccines)

• Incentives• Ensure safety

monitoring• Manage anti-vaxxers

• Sharing experiences from other countries

• Investment in surveillance

• Strengthen NITAG• Strategies to

manage supply and demand

• Consider mandates• Develop new ways

to deliver vaccines quickly

• Remove stringent requirements

• Communicate broader value of immunization

• Demonstrate impact on younger generation

• Focus on reducing out of-pocket-costs

• Expand access (e.g., pharmacists)

• Communicate value of independence

• Boost childhood immunization rates & look for synergies to offer services

• Immunize health workers

• Build vaccine confidence

• Safety monitoring• Private sector

engagement?• Advocacy

Few have adult immunization

experience

Understand differences in epidemiology

Surveillance may be limited, but experience

with outbreaks (e.g., Ebola, meningitis)

Younger populationsUniversal health

coverage: treatment focused?

Will older adults access the same immunization

system as children?

What about LMICs?

Summary

1. Immunization with existing vaccines can help, but we must strengthen adult vaccine decision-making and implementation

2. A better understanding of contributions of adult vaccines by decision-makers, providers and the public needed

3. Differing priorities of countries require different approaches

4. Need to be thinking about delivery for COVID-19 vaccines to older adults now

Picture: NIH.

Picture: Steemit.

Picture: EPR.

Q&A

jhsph.edu/ivac

Thank you to Prar Vasudevan for her contributions to this work

Please contact lprivor1@jhu.edu with comments.

Thank you!